HEMOTHORAX
BLOOD in the PLEURAL SPACE
How to EVALUATE someone for INFLAMMATORY JOINT DISEASE
Systemic signs of inflammation:
- FEVER
- LEUKOCYTOSIS
- MALAISE
- ANOREXIA
- HYPERFIBRINOGENEMIA
RA:
- PAINFUL, TENDER, STIFF, WARM, SWOLLEN joints
SEROLOGY evaluation of RF/ACPA (serum markers can be present for years to decades before recognized)
B12 DEFICIENCY ANEMIA
PERNICIOUS ANEMIA
- Most common macrocytic anemia (large RBCs –> die prematurely, defective DNA synthesis)
- Caused by VITAMIN B12 DEFICIENCY
- LACKS INTRINSIC FACTOR from GASTRIC PARIETAL CELLS (REQUIRED for B12 ABSORPTION)
RISK FACTORS: GASTRECTOMY, ILEAL RESECTION (small bowel), PROTON PUMP INHIBITORS
Treatment: WEEKLY/MONTHLY INJECTIONS or HIGH ORAL DOSES of VITAMIN B12
FOLATE DEFICIENCY ANEMIA
- MACROCYTIC, NORMOCHROMIC
- LOW RETICULOCYTES (slightly immature RBCs; tested w/blood smear)
- NORMAL IRON LEVEL
SMALL BOWEL OBSTRUCTION SYMPTOMS
- Colicky pains
- INTESTINAL/ABDOMINAL DISTENTION (CAT Scan will show collection)
- NAUSEA
- VOMITING
PREVENTIVE MEDICINE EDUCATION with regards to TESTICULAR CANCER
- CANCER of the TESTIS
- Among MOST CURABLE of cancers
- EDUCATION and SCREENING is IMPERATIVE
- COMMON in MEN BETWEEN 14 - 44 years of age
Preventive medicine education regarding testicular cancer primarily focuses on increasing awareness and promoting early detection practices among at-risk populations, particularly young men aged 15-35 years. Testicular self-examination (TSE) is a key component of this educational effort, although its routine recommendation is controversial.
ABNORMAL UTERINE BLEEDING
- IRREGULAR (METRORRHAGIA) and EXCESSIVE (MENORRHAGIA) BLEEDING or both (MENOMETRORRHAGIA)
- May involve FLOODING and the PASSAGE OF LARGE CLOTS leading to EXCESSIVE BLOOD LOSS
- Also can lead to IRON DEFICIENCY ANEMIA
CAUSES of HIRSUTISM
- PCOS
- ADRENAL HYPERPLASIA
- ADRENAL TUMORS
- Secondary amenorrhea
ANOREXIA of AGING CONTRIBUTING FACTORS
- WANING HUNGER/LOSS OF APPETITE
- DIMINISHED SENSE OF TASTE AND SMELL
- DECREASED PRODUCTION OF SALIVA
- SOCIAL ISOLATION
CYSTOCELE vs. RECTOCELE
PROLAPSE OF BLADDER vs. RECTUM
LEIOMYOMA
- myoma or UTERINE FIBROID
- BENIGN TUMORS of SMOOTH MUSCLE CELLS in MYOMETRIUM
STAGES of SYPHILIS
- Primary - local manifestations (3 weeks)
- SECONDARY - SYSTEMIC
– BLOODBORNE BACTERIA SPREAD to ALL MAJOR ORGAN SYSTEMS (variable sxs - low grade fever, malaise, sore throat, headache, pain, etc.) - Latent - asymptomatic
- Tertiary - most severe w/destructive systemic manifestations
ROUTES of TRANSMISSION for HEPATITIS A, B, C, and D
B/D – SEXUALLY TRANSMITTED (needle puncture, blood transfusion, cuts or abrasions in the skin, and ABSORPTION BY MUCOSAL SURFACES)
C – injecting drug use, sexual, transfusion, health-related work
A – fecal-oral route (contaminated food, person-to-person contact incl. sexual contact)
BENIGN PROSTATIC HYPERPLASIA (BPH)
- ENLARGEMENT of the PROSTATE GLAND
- URETHRAL COMPRESSION (urge to urinate often, delay in starting urination, decreased force of urinary stream)
PORTAL HYPERTENSION
- VARICES = DISTENDED, TORTUOUS, COLLATERAL VEINS (enlarged and winding veins that develop as alternative pathways for blood flow when the normal venous routes are obstructed. These collateral veins form in response to increased venous pressure)
- MOST COMMONLY in LOWER ESOPHAGUS
HYPOTHYROIDISM
- COLD INTOLERANCE
- LETHARGY
- CONSTIPATION
- DRY SKIN
ASTHMA
- CHRONIC INFLAMMATORY DISORDER
- MUCOSAL EDEMA
- REVERSIBLE AIRFLOW OBSTRUCTION
- BRONCHIAL HYPERRESPONSIVENESS
- AIRWAY CONSTRICTION
- EPISODIC ATTACKS OF BRONCHOSPASM
- BRONCHIAL INFLAMMATION
- INCREASED MUCUS PRODUCTION
TYPE 1 VS. TYPE 2 DIABETES MELLITUS
TYPE 1:
- PANCREATIC ATROPHY
- LOSS OF BETA CELLS
- AUTOIMMUNE or NONIMMUNE/SECONDARY
- GENETIC SUSCEPTIBILITY
TYPE 2:
- more common
- INSULIN RESISTANCE (RESPONSE of INSULIN-SENSITIVE TISSUES [esp. in liver, muscle, adipose tissue] to INSULIN IS SUBOPTIMAL)
- decreased insulin secretion
- beta cell dysfunction
MICROVASCULAR COMPLICATION risks associated w/DIABETES
- DIABETIC RETINOPATHY (EYES)
- DIABETIC NEPHROPATHY (KIDNEYS) – requires CLOSE MONITORING OF RENAL FUNCTION
- DIABETIC NEUROPATHIES (NERVES, PERIPHERAL NEUROPATHY)
- MICROALBUMINURIA (SPILLING PROTEIN IN URINE)
THYROTOXIC CRISIS
- HYPERTHERMIA
- TACHYCARDIA
- atrial tachydysrhythmias
- high-output heart failure
- agitation or delirium
- nausea, vomiting, diarrhea
HYPOGLYCEMIA
- TACHYCARDIA
- HUNGER
- LIGHTHEADEDNESS
- PALPITATIONS
- DIAPHORESIS
- TREMORS
- PALLOR
- CONFUSION
- IRRITABILITY
- caused by TOO MUCH INSULIN, NOT ENOUGH FOOD, INCREASED AMOUNT OF EXERCISE
ADDISON DISEASE vs. CUSHING’S SYNDROME vs. CUSHING-LIKE SYNDROME
ADDISON DISEASE:
- primary adrenal insufficiency
hypocortisolism
CUSHING’S SYNDROME:
- chronic excessive cortisol level
- TRUNCAL (CENTRAL) OBESITY
- EASY BRUISING, ACNE, THIN EXTREMITIES
CUSHING-LIKE SYNDROME:
- Exogenous administration of GLUCOCORTICOIDS
OBESITY CLASSES
VISCERAL OBESITY (intraabdominal, central, or masculine – distribution of body fat localized around abdomen and upper body)
PERIPHERAL OBESITY (gluteal-femoral, feminine, or subcutaneous – distribution of body fat distributed around thighs and buttocks through muscle)
- Class I Obesity (Mild Obesity): BMI of 30.0 to 34.9 kg/m².
- Class II Obesity (Moderate Obesity): BMI of 35.0 to 39.9 kg/m².
- Class III Obesity (Severe or Extreme Obesity): BMI of 40.0 kg/m² or higher.
COMPLICATIONS associated w/STARVATION/ANOREXIA
- GLYCOGENOLYSIS (splitting glycogen into glucose)
- GLUCONEOGENESIS (formation of glucose from noncarbohydrate molecules)
- KETOSIS and ACIDOSIS (electrolyte abnormalities)
- skeletal muscle wasting/muscular atrophy
